- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $74.13 / $512.86
| Facility | | $74.13 | $74.13 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $112.20 / $316.23
| Professional | | $75.86 | $112.20 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $407.38 / $776.25
| Facility | | $123.03 | $407.38 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $776.25
| Professional | | $93.33 | $147.91 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $331.13 / $478.63
| Facility | | $263.03 | $331.13 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $457.09 / $1,548.82
| Facility | | $213.80 | $457.09 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $162.18 / $316.23
| Professional | | $89.13 | $162.18 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $173.78 / $8,511.38
| Facility | | $97.72 | $173.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.44 / $138.04 / $251.19
| Professional | | $23.44 | $138.04 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $181.97 / $346.74
| Professional | | $114.82 | $181.97 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $407.38 / $776.25
| Facility | | $123.03 | $407.38 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $776.25
| Professional | | $93.33 | $147.91 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $338.84 / $691.83
| Facility | | $29.51 | $338.84 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $147.91 / $309.03
| Professional | | $100.00 | $147.91 | $309.03 |